Something important happens when you take a long, hard look at your revenue cycle. You start to see not just potential problems to side-step, but opportunities to seize upon. From the time a patient is scheduled to final billing and account resolution, there are numerous opportunities for things to go wrong. Demographic information is entered incorrectly. Charges are missed. CPT codes are outdated. Claims are denied. The revenue cycle is full of risks. Protiviti's Revenue Risk Solutions™ are a suite of tools and methodologies to identify and prioritize your risks, enhance internal controls and improve operating efficiencies.

Knowledge is power, and knowing your revenue cycle risks empowers you to control the threats to your financial, compliance and operating performance. To help give you this knowledge, Protiviti starts with interviews of administration and process owners to identify your risk areas. We then use that information to develop process maps to visualize the revenue cycle processes. This creates a platform for identifying your risk areas and the mitigating controls. Next, we develop a Risk and Control Matrix to identify control gaps that threaten to undermine your performance. Then we collaborate with you to create cost-effective, workable control solutions. Finally, we test those controls to ensure that they are working properly and adjust as necessary. Throughout our approach, we look for opportunities to improve your organization across the six key elements of infrastructure.

The result is the acceleration of your revenue cycle performance without the high costs of extensive re-engineering. Unlike the many quick fixes available, effective internal controls mean sustainable performance improvement. Procedures are documented and standardized. Resources are well trained and allocated effectively and efficiently. Information is available when needed. This is the kind of performance that delivers the results you need to achieve your objectives.

  • Tightens controls around your existing revenue cycle processes and systems without the high cost of extensive re-engineering.
  • Enhances revenues.
  • Minimizes compliance risks.
  • Aligns with electronic health records.
  • Aligns with Sarbanes-Oxley efforts.
  • Prepares your organization for future audits across the revenue cycle.

Who is Protiviti?

Protiviti is a leading international provider of independent internal audit and business and technology risk consulting services. We help companies worldwide identify, measure and manage operational and technology-related risks they face within their industries and throughout their systems and processes. We offer a full spectrum of internal audit services, technologies and skills for business risk management and the continual transformation of internal audit functions.

At Protiviti, we believe the companies that most effectively understand and manage their risks are the companies that most often succeed. Or, as we like to say, “Know Risk. Know Reward.™”

Learn more at protiviti.com.

Learn more about each of Protiviti's solutions for Healthcare Revenue Risk management.
Revenue Risk Solutions
Charge Capture
Clinical Application Implementation
Denials Management
Pricing Solutions

Protiviti Healthcare Solution Overview

If you would like more information or the opportunity to talk about Revenue Risk Management with one of our solution leaders, please contact one of the following individuals.

Grant Baumgartner
Managing Director, Seattle
Grant.Baumgartner@protiviti.com
206.262.2912
Richard Williams
Associate Director, Dallas
Richard.Williams@protiviti.com
469.374.2469
Richard Gould
Senior Manager, Seattle
Richard.Gould@protiviti.com
206.262.2917

 

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